| 1. |
- Ceder, Gunnel, et al.
(författare)
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Concentration ratios of morphine to codeine in blood of impaired drivers as evidence of heroin use and not medication with codeine
- 2001
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Ingår i: Clinical Chemistry. - 0009-9147 .- 1530-8561. ; 47:11, s. 1980-1984
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Tidskriftsartikel (refereegranskat)abstract
- Background: Both the illicit drug heroin and the prescription drug codeine are metabolized to morphine, which tends to complicate interpretation of opiate-positive samples. We report here the concentrations of morphine and codeine, the morphine/codeine ratios, and 6-acetylmorphine (6-AM) in blood specimens from individuals arrested for driving under the influence of drugs (DUID) in Sweden. The results were compared with positive findings of 6-AM in urine as evidence of heroin intake. Methods: In 339 DUID suspects, both blood and urine specimens were available for toxicologic analysis. In another 882 cases, only blood was available. All specimens were initially analyzed by immunoassay, and the positive results were verified by isotope-dilution gas chromatography-mass spectrometry. In routine casework, the limits of quantification (LOQs) for unconjugated opiates were 5 ng/g for blood and 20 ╡g/L for urine. Results: The median concentration of morphine in blood was 30 ng/g with 2.5 and 97.5 percentiles of 5 and 230 ng/g, respectively (n = 979). This compares with a median codeine concentration of 20 ng/g and 2.5 and 97.5 percentiles of 5 and 592 ng/g, respectively (n = 784). The specific metabolite of heroin, 6-AM, was identified in only 16 of 675 blood specimens (2.3%). This compares with positive findings of 6-AM in 212 of 339 urine samples (62%) from the same population of DUID suspects. When 6-AM was identified in urine, the morphine/codeine ratio in blood was always greater than unity (median, 6.0, range, 1-66). In 18 instances, 6-AM was present in urine, although morphine and codeine were below the LOQ in blood. The morphine/codeine ratio in blood was greater than unity in 85% of DUID cases when urine was not available (n = 506), and the median morphine and codeine concentrations were 70 ng/g and 10 ng/g, respectively. When morphine/codeine ratios in blood were less than unity (n = 76), the median morphine and codeine concentrations were 10 ng/g and 180 ng/g, respectively. Conclusions: Only 2.3% of opiate-positive DUID suspects were verified as heroin users on the basis of positive findings of 6-AM in blood. A much higher proportion (62%) were verified heroin users from 6-AM identified in urine. When urine was not available for analysis, finding a morphine/codeine concentration ratio in blood above unity suggests heroin use and not medication with codeine. This biomarker indicated that 85% of opiate-positive DUID blood samples were from heroin users. ⌐ 2001 American Association for Clinical Chemistry.
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| 2. |
- Ceder, Gunnel, et al.
(författare)
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Trafik och läkemedel
- 2009
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Ingår i: FASS 2009. - Stockholm : Läkemedelsindustriföreningen (LIF). - 9789185929023 ; , s. 2997-2999
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Bokkapitel (populärvet., debatt m.m.)
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| 3. |
- Ceder, Gunnel, et al.
(författare)
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Trafik och läkemedel
- 2005
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Ingår i: FASS. ; , s. 2204-2206
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Bokkapitel (övrigt vetenskapligt/konstnärligt)
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| 4. |
- Ceder, Gunnel, et al.
(författare)
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Trafik och läkemedel
- 2003
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Ingår i: FASS 2003. ; , s. 1837-1839
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Bokkapitel (övrigt vetenskapligt/konstnärligt)
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| 5. |
- Ceder, Gunnel, et al.
(författare)
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Trafik och läkemedel
- 2004
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Ingår i: FASS 2004. ; , s. 1927-1929
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Bokkapitel (övrigt vetenskapligt/konstnärligt)
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| 6. |
- Ceder, Gunnel, et al.
(författare)
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Trafik och läkemedel
- 2006
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Ingår i: FASS 2006. ; , s. 2827-2829
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Bokkapitel (övrigt vetenskapligt/konstnärligt)
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| 7. |
- Ceder, Gunnel, et al.
(författare)
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Trafik och läkemedel
- 2007
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Ingår i: FASS 2007. ; , s. 2164-2166
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Bokkapitel (övrigt vetenskapligt/konstnärligt)
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| 8. |
- Ceder, Gunnel, et al.
(författare)
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Trafik och läkemedel
- 2008
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Ingår i: FASS 2008. ; , s. 2380-2382
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Bokkapitel (övrigt vetenskapligt/konstnärligt)
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| 9. |
- Forsman, Åsa, et al.
(författare)
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Förekomst av droger och läkemedel i trafik i Sverige : resultat från EU-projektet DRUID
- 2011
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Rapport (övrigt vetenskapligt/konstnärligt)abstract
- The prevalence of illicit drugs and medicines in the driving population, i.e. among drivers on the road, was 2.5 per cent between the years 2006 and 2011 in Sweden. The prevalence of alcohol, illicit drugs and medicines among drivers killed in traffic the same years was 31.2 per cent. In comparison with other countries in the EU project DRUID, Sweden has the highest proportion of negative results, i.e. drivers without the presence of alcohol, drugs or medicine. This applies to both drivers on the road and drivers killed in traffic.The studies that form the basis of this report have been performed within the project DRUID - Driving under the influence of drugs, alcohol and medicine, which is a project within the EU's Sixth Framework Programme, which lasted five years (2006-2011). This report presents two sub-studies from the DRUID project. The aims of these studies were: - to study the prevalence of illicit drugs and medicines in the driving population (study among drivers on the road). - to study the prevalence of alcohol, illicit drugs and medicines among killed drivers (study of killed drivers).In the study among drivers on the road, saliva samples were collected. Toxicological results were analysed from 6,199 drivers in Södermanland, Örebro and Östergötland out of 10,223 drivers of passenger cars and vans that were stopped by the police in March 2008- February 2009. In the study of killed drivers we have toxicological results from 157 fatalities out of 178 drivers of passenger cars and vans that were killed in traffic accidents in 2008.
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| 10. |
- Hjälmdahl, Magnus, et al.
(författare)
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Effects of d-amphetamine on simulated driving performance before and after sleep deprivation
- 2012
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Ingår i: Psychopharmacology. - : Springer Berlin/Heidelberg. - 0033-3158 .- 1432-2072. ; 222:3, s. 401-411
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Tidskriftsartikel (refereegranskat)abstract
- Stimulant drugs are commonly abused and also used to promote wakefulness, yet their effects on driving performance during sleep deprivation have not been thoroughly researched in experimental studies. The aims were to assess the effects on fundamental driving parameters during simulated driving of two doses of d-amphetamine and further to assess the interaction between d-amphetamine and sleep deprivation. A double-blind, placebo-controlled experiment including 18 healthy male volunteers was conducted. The participants felt more alert when taking a dose of d-amphetamine than when taking placebo, and the effect was stronger for the higher dose. However, the data did not show any evidence that taking d-amphetamine prevented the subjects from becoming successively sleepier during the night. A significant main effect of the dose was found for three out of the five primary indicators where the lower dose led to improved driving. These indicators were crossing-car reaction time, and coherence and delay from a car-following event. Regarding sleep deprivation, a main effect was found for four of the primary indicators and three of the secondary indicators. The results showed overall impaired driving with respect to standard deviation of lateral position and delay in reaction time when the sleep-deprived conditions were compared to the alert condition. We found no interactions between dose and sleep deprivation for any of the performance indicators. Our results suggest that administration of d-amphetamine does not compensate for impairment of driving due to fatigue. The positive effects of 10 mg were not further improved or even sustained when increasing the dose to 40 mg.
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| 11. |
- Legrand, Sara-Ann, et al.
(författare)
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Prevalence of alcohol, illicit drugs and psychoactive medicines in killed drivers in four European countries
- 2013
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Ingår i: International Journal of Injury Control and Safety Promotion. - : Taylor & Francis. - 1745-7300 .- 1745-7319. ; 21:1, s. 17-28
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Tidskriftsartikel (refereegranskat)abstract
- Our objective was to determine the presence of psychoactive substances in blood of drivers killed in road crashes in four European countries. Data from 1118 drivers of car and vans, killed between 2006 and 2009, were collected in Finland, Norway, Portugal and Sweden. The prevalence of any psychoactive substance ranged between 31 and 48%.Alcohol (>= 0.1 g/L) was the most common finding, 87% had a blood alcohol concentration (BAC)>=.5 g/L. Benzodiazepines (1.8-13.3%) and amphetamines (0-7.4%) were the most prevalent psychoactive medicines and illicit drugs, respectively. Alcohol-drug and drug-drug combinations were rather prevalent. Differences in alcohol/drug findings seemed to reflect differences in use in the countries. More research should be done to develop preventive strategies to reduce the number of alcohol- and drug-related traffic accidents targeting at-risk groups, such as drivers with very high BACs and novice drivers.
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| 12. |
- Morland, Jørg, et al.
(författare)
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Drugs related to motor vehicle crashes in northern European countries : A study of fatally injured drivers
- 2011
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Ingår i: Accident Analysis and Prevention. - : Elsevier. - 0001-4575 .- 1879-2057. ; 43:6, s. 1920-1926
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Tidskriftsartikel (refereegranskat)abstract
- The aim of this study was to find which drugs and drug combinations were most common in drivers who died, in particular, in single vehicle crashes where the responsibility for the crash would be referred to the driver killed. The study included all available blood samples from drivers, who died within 24h of the accident, in the years 2001 and 2002 in the five Nordic countries (total population about 24 million inhabitants). The samples were analysed for more than 200 different drugs in addition to alcohol, using a similar analytical programme and cut-off limits in all countries. In three countries (Finland, Norway and Sweden) blood samples were available for more than 70% of the drivers, allowing representative prevalence data to be collected. 60% of the drivers in single vehicle crashes had alcohol and/or drug in their blood samples, compared with 30% of drivers killed in collisions with other vehicles. In single vehicle accidents, 66% of the drivers under 30 years of age had alcohol and/or drugs in their blood (alcohol only - 40%; drugs only - 12%; alcohol and drugs - 14%). The drugs found were mostly illicit drugs and psychoactive medicinal drugs with warning labels (in 57% and 58% respectively of the drivers under 30 with drugs present). Similar findings were obtained for drivers 30-49 years of age (63% with alcohol and/or drugs). In drivers aged 50 years and above, killed in single vehicle crashes (48% with alcohol and/or drugs) illicit drugs were found in only one case, and psychoactive medicinal drugs were detected less frequently than in younger age groups. In 75% of single vehicle crashes, the driver was under 50 years. Thus, the majority of accidents where the drivers must be considered responsible, occurred with drivers who had recently used alcohol, or drugs, alone or in combination. The drugs involved were often illicit and/or psychoactive drugs with warning labels. Therefore a large proportion of single vehicle accidents appear to be preventable, if more effective measures against driving after intake of alcohol and drugs can be implemented.
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